The Epidemiology, Risk Factors and Clinical Presentation of Dermatophytosis in India

Superficial dermatophytosis is a commonly encountered infective dermatoses in clinical practice. The incidence of dermatophytosis has increased in India over the past decade, with the reported prevalence ranging between 6.09% and 61.5%. There has been a rise in the incidence of chronic, relapsing and recurrent dermatophytosis.

Dermatophytosis is usually most often seen in postpubertal age, except for tinea capitis, and men are usually more frequently affected than women. However, the scenario is changing now. People from the lower socioeconomic status continue to be more prone to develop the infection. Those involved in outdoor activities in hot and humid environments have an increased risk of infection. Rampant, irrational use of topical steroids and combination creams seems to be tied to the increasing cases of chronic and recalcitrant dermatophytosis. Additionally, there has been an epidemiological shift with Trichophyton mentagrophytes replacing T. rubrum as the predominant organism.

There have been several changes in the clinical presentation of superficial dermatophytosis in India. These include sudden appearance and rapid spread of lesions, early involvement of distant areas, varying degrees of inflammation, spread to family members, eczema/dryness after infection causing persistent itch, flare up of lesions with increased inflammation after starting treatment, concomitant bacterial infections and chronic dermatophytosis, recurrences, relapses becoming common.

It is not necessary to see the well-defined, centrifugally spreading lesions with central clearing now. The morphology of lesions has been changing with common forms seen now including steroid-modified tinea, double-edged tinea, eczematous lesions and tinea that mimics other dermatoses.

The involvement of several body sites is common. Superficial dermatophytosis now involves unusual locations such as genital dermatophytosis, superficial dermatophytosis of scalp skin, Tinea auricularis, Tinea labialis, Tinea blepharitis and ciliaris, and Tinea of vellus hair.

Itching is a prominent feature of superficial dermatophytosis. There is often disabling itch, with frequent aggravation at night. Itch may persist after lesions resolve.

In conclusion, superficial dermatophytosis now occurs regardless of age, sex, climatic changes, and educational or socioeconomic status. There is a high rate of transmission among family members and close contacts. Chronic, recurrent and relapsing dermatophytosis is also increasing.

Reference

Verma SB, Panda S, Nenoff P, et al. Indian J Dermatol Venereol Leprol 2021;87:154-75.

(This Information is Meant For a Registered Medical Practitioner Only)